Internal Auditor

Position SummaryThe Internal Auditor conducts internal reviews of provider documentation, coding, billing, reimbursement, and revenue cycle processes for Associated Eye Care, AEC Ambulatory Surgery Center, and AEC Optical. The position identifies compliance and revenue risks, evaluates documentation and coding accuracy, recommends corrective actions, and provides education to providers and staff. The Internal Auditor collaborates with the Director of Revenue Cycle and other organizational leaders on audit priorities, compliance concerns, and process improvement. The position also provides Business Office Representative coverage as needed to maintain departmental operations.Expected compensation between $26.59 - $31.91/hour. Compensation will be determined based on relevant experience and skills.Internal Auditor Essential FunctionsPerforms internal audits of provider documentation, coding, billing, charge capture, claims, payments, adjustments, denials, and other revenue cycle activities for Associated Eye Care, AEC Ambulatory Surgery Center, and AEC Optical to identify documentation deficiencies, coding errors, compliance risks, reimbursement opportunities, and workflow improvement initiatives; communicates findings and recommendations to providers, staff, and leadership, and provides education and training based on audit results.Works collaboratively with Operations, Clinical, Surgical, Optical, and Revenue Cycle personnel when changes in equipment, devices, procedures, studies, workflows, or payer requirements may affect documentation, coding, billing, or reimbursement.Provides ongoing review, education, and oversight of resident documentation and billing practices to support training, compliance, credentialing, payer enrollment, and applicable supervision and billing requirements.Maintains current knowledge of coding guidelines, payer policies, reimbursement requirements, and organizational policies relevant to assigned responsibilities.Participates in external audits, payer reviews, and governmental or contractor requests by gathering records, organizing supporting documentation, preparing audit reports and workpapers, maintaining confidential audit records, monitoring deadlines, and assisting with responses and follow-up activities as assigned.Provides Business Office Representative coverage during absences, staffing shortages, workload increases, or other operational needs, including assigned support with charges, payments, adjustments, claims, and patient account inquiries.Other Essential FunctionsMust present self at the workstation, ready for work, at the scheduled timeCreate an exceptional patient experienceCommunicate effectively with supervisor, manager, and/or directorParticipate in department and company meetings, as requestedWork as a team with other departmentsPerforms other duties as assignedEducation & LicensingHigh School Diploma or equivalent required.Active coding certification required, such as CPC, CCS-P, CCS, OCS, or equivalent.CPMA, COPC, OCS, or other auditing/compliance specialty certification preferred.Must maintain required certifications and continuing education requirements.ExperienceMinimum three years of healthcare billing, coding, auditing, compliance, or revenue cycle experience required.Experience with provider documentation review and coding audits preferred.Experience educating providers and staff on coding and documentation requirements preferred.Ophthalmology and ambulatory surgery center billing experience preferred.NextGen experience preferred.Proficient in Microsoft Word and Excel with willingness to learn new software applications.Skills & Knowledge RequiredKnowledge of medical billing, coding, auditing, provider documentation requirements, and payer guidelines.Strong analytical, critical thinking, and problem-solving skills.Ability to identify documentation deficiencies, coding errors, compliance risks, and reimbursement opportunities.Ability to interpret and apply CPT, ICD-10-CM, HCPCS, payer policies, and regulatory requirements.Ability to analyze data, identify trends, and recommend process improvements.Effective written and verbal communication skills, including the ability to present audit findings and provide education to the providers and staff.Ability to work independently, prioritize workload, and manage multiple deadlines.Strong attention to detail, organization, and accuracy.Proficiency in Microsoft Office, EHR, and practice management systems.Ability to maintain confidentiality and exercise sound professional judgment.Comprehensive Benefits PackageHealth insuranceDental insuranceEmployer paid life and accidental death and dismemberment benefitEmployee assistance program (EAP) benefitCompany matched 401(k) planFlex spending accounts (medical and dependent care)Health Savings AccountVoluntary Benefits and Life Insurance CoveragePTO – Accrual begins on Date of HireFloating Holiday DayAnnual Scrubs allowance for clinic employeesFree annual eye exams for you and your immediate familySignificant discounts on our services and products for employee and immediate family membersJob Type: Full-timeAssociated Eye Care is an Equal Opportunity/Affirmative Action Employer #J-18808-Ljbffr Priority Dispatch Corp.